As a registered nurse and director of patient services for the Chautauqua County Health Department in western New York, Wendy Douglas conducted case investigations and monitoring during the COVID-19 pandemic. The experience laid bare the disparities public health departments are designed to address but not all workers are equipped to encounter.

“Very few of our health department’s employees have any public health background when they start working here, and it sometimes shows,” Douglas said. “For example, there can be a lack of understanding of health equity.”

Credit: Jason Koski/Cornell University

The issue is nationwide in scale. On-the-job experience is the only source of public health training for most professionals in governmental agencies. Only 14% of those workers have received formal higher education in the field. To close the skills gap that is, in part, responsible for the profession’s decadeslong workforce decline, a team of Cornell faculty members and researchers – led by Gen Meredith, an associate professor in the College of Veterinary Medicine’s Department of Public and Ecosystem Health – partnered with eCornell to launch the university’s Public Health Essentials online certificate program.

More than 1,230 people across the nation have enrolled to earn the certificate since September 2021. Of those, 1,160 are from New York, including 567 who participated through a signature fellowship program with the New York State Department of Health. Due to its success, the state will extend its program in August to engage 200 new fellows. Applications for the next cohort are open through June 28.

“Public health is what we do collectively to ensure conditions that allow for access to health and well-being for all,” said Meredith, who also serves as the associate director of Cornell’s Public Health Program. “As a profession, our efforts prevent injury and disease, promote physical, mental and social health, and prolong life. This is achieved through systems, data and assessment to understand community needs, disparities and ways to take action for continuous improvement. The Public Health Essentials program is designed to give learners the tools for this work.”

In 2022, researchers estimated that at least 1,000 new workers were needed in New York to support core public health functions. Now the New York State Public Health Corps (NYSPHC) Fellowship Program, established in 2021 to support COVID-19 response and recovery efforts, is helping the state increase capacity and preparedness for future public health emergencies. Sixty percent of the fellows have arrived to the program with fewer than two years of public health experience.

Training, education, mentorship

Cornell’s Public Health Essentials certificate program, offered through eCornell, is the fellowship’s primary educational component.

“Our mission is to provide professional development opportunities that enhance public health knowledge through training, education and mentorship,” said Ashley Tate, assistant director for NYSPHC. “The Public Health Essentials courses allow fellows to gain foundational knowledge and expose them to public health practice that applies to their current work and beyond.”

Like all learners in the 15-week certificate program, fellows work toward achieving core competencies adapted from the de Beaumont Foundation’s Strategic Skills. They examine health equity practices, interpret data and strengthen their ability to communicate with citizens and support them in preventing infection and illness.

Fellows are matched with mentors for personal guidance. They also attend an annual in-person summit, regional consortia and webinars to hear directly from experts, expand their networks and advance their strategic skills on emerging public health activities and state priorities.

Douglas completed Public Health Essentials with four other staffers from her department whose experience in the field ranged from three to 25 years. Just one member of the group holds a master’s degree in public health.

“It is really valuable to have these resources to guide us in doing things properly, especially when concluding and evaluating our efforts,” Douglas said. “We have kept the program materials for future reference and will use the models and planning processes in future grant applications and in doing our work.”

In addition to addressing COVID-19, fellows are involved with core public health programming and special projects, including wastewater surveillance, immunization clinics, menstrual health product distribution, education campaigns, community health assessments and resilience through community gardening.

“Cornell is a trusted partner with experience in educating learners of all levels,” Tate said. “Having Cornell as a collaborator has allowed us to target the training needs of our fellows and customize the program where necessary.”

One factor that sets Cornell’s programs apart, Meredith said, is an interdisciplinary approach.

“COVID-19 was an unprecedented global challenge in which a novel virus jumped from an animal to a person. Our health care and public health systems were not prepared to detect, prevent and respond to the emerging pandemic,” she said. “By design, our faculty brings together expertise from human, animal and environmental health as well as climate science. This was especially important in responding to the pandemic, and we wanted to be part of the solution.”

As New York’s land-grant institution, Cornell was ready to deliver courses that efficiently compress complex content for diverse learners, meeting the immediate needs of NYSPHC and the national program.

Building capacity

The program is extensive, covering factors that impact health and contribute to health disparity, tactics to improve health outcomes, community intervention plans and strategies for increasing influence on public health behaviors. Learners apply assessment models, data analysis methods and best practices in communication to real-world circumstances.

“eCornell gave us the systems and tools to build capacity among critical workers quickly and in the right way,” Meredith said. “As we build our programs to train the future public health workforce, we strive to ensure equity and access, recognizing that there are many people currently working who can’t press pause and go back to school and there are people who want to build their skills in real time to be more effective in their jobs.”

Those who complete the program earn certificates and receive “skills cards” that showcase their development in several areas such as data-based decision-making and community engagement. NYSPHC works to hire fellows from traditionally marginalized populations, and all fellows complete training in health equity, social determinants of health, racial equity, social justice, cultural competency and working with underserved populations.

“The Cornell courses gave me an understanding of what public health departments do and how to address misinformation and disinformation about the COVID-19 pandemic, tailoring messaging for everyone regardless of literacy level,” said Brandin Cousineau, who was recently graduated from college when he began the program and is now an accreditation coordinator for the St. Lawrence County Public Health Department, drafting and facilitating the department’s strategic plan and staff code of conduct. He is also developing an ethics committee and its charter.

“Collaborating with fellows and mentors from different backgrounds helped show me there is not only one avenue for a career path in public health,” he said. “Some fellows were communication or business administration majors. Diverse perspectives can help improve internal processes and can be an asset in helping improve the workforce shortage of public health professionals.”

More than 170 NYSPHC fellows have accepted full-time positions in the public health or health care sectors. Almost a third of those roles are with the state’s Department of Health. Meredith’s team is developing an additional public health leadership certificate to help fellows continue building skills and confidence for progressive leadership roles.

“The program helped put what we know into frameworks and filled gaps in our understanding,” Douglas said. “It validated that we have learned a great deal about public health theory and practice on the job. More than anything, the program has given us more confidence in our work.”

Cornell’s Public Health Essentials online certificate program is open for enrollment from public health workers and volunteers, outreach coordinators and others interested in well-being, disease and injury prevention or health equity leadership.

Torie Michelle Anderson is a writer for eCornell.